Learn About Preeclampsia Signs and Symptoms

Understanding Preeclampsia: Definition and Overview

Preeclampsia is a serious medical condition that can develop during pregnancy, typically after the 20th week of pregnancy. The condition involves high blood pressure and signs of damage to another organ system, most often the kidneys. According to the Centers for Disease Control and Prevention, preeclampsia affects about 1 in 25 pregnancies in the United States. This condition requires medical monitoring and treatment to prevent serious complications for both the pregnant person and the developing baby.

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The word "preeclampsia" comes from the medical understanding that the condition can develop before eclampsia, which is a more severe form involving seizures. However, not all cases of preeclampsia progress to eclampsia. The condition develops when the placenta—the organ that nourishes the baby during pregnancy—does not function properly, leading to changes in blood vessels and blood pressure regulation.

Preeclampsia is categorized into two main types based on when it occurs. Preeclampsia that develops before 34 weeks of pregnancy is called early-onset preeclampsia, which tends to be more severe. Preeclampsia that develops at 34 weeks or later is called late-onset preeclampsia. Both types require medical attention, but early-onset cases typically involve more intensive management and monitoring.

Understanding preeclampsia is important because recognizing its signs early allows healthcare providers to monitor the condition and take steps to prevent complications. The condition can affect the baby's growth, cause premature delivery, and in rare cases, lead to serious health problems or death for both mother and baby if left untreated. Regular prenatal care and communication with healthcare providers about symptoms plays a central role in managing this condition.

Practical Takeaway: Preeclampsia is a pregnancy condition involving high blood pressure that requires medical monitoring. Learning about its signs helps pregnant people communicate effectively with their healthcare team about any concerning symptoms.

Blood Pressure Changes: The Primary Warning Sign

High blood pressure is the hallmark sign of preeclampsia. In pregnancy, blood pressure is typically monitored at each prenatal visit to establish a baseline. Preeclampsia is usually defined as a blood pressure reading of 140/90 mmHg or higher on two separate occasions at least four hours apart, measured after 20 weeks of pregnancy. For people with chronic high blood pressure before pregnancy, preeclampsia is diagnosed when blood pressure increases by 30 mmHg systolic or 15 mmHg diastolic from baseline readings taken earlier in pregnancy.

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The systolic number (the first number in a blood pressure reading) measures pressure when the heart beats, while the diastolic number (the second number) measures pressure when the heart rests between beats. A reading of 140/90 represents elevated pressure that differs from the normal ranges typically seen in healthy pregnancy. Many pregnant people may not notice high blood pressure because it often causes no symptoms, which is why regular monitoring during prenatal visits is essential.

Some pregnant people describe mild headaches or feel "off" when their blood pressure becomes elevated, but these symptoms are not specific to preeclampsia and can occur with other conditions as well. The only reliable way to know if blood pressure is elevated is through measurement using a blood pressure cuff. This is why healthcare providers check blood pressure at every prenatal appointment, even when the pregnant person feels completely fine.

Understanding blood pressure readings helps pregnant people participate in their own care. If a healthcare provider mentions that blood pressure is elevated or has risen significantly since the last visit, asking questions about what this means and what monitoring will follow is appropriate. Home blood pressure monitoring may be recommended for some pregnant people to track readings between office visits, providing healthcare providers with additional information about overall blood pressure patterns.

Practical Takeaway: High blood pressure is the main sign of preeclampsia, often without noticeable symptoms. Regular blood pressure checks at prenatal visits are essential for early detection, which is why attending all scheduled appointments matters.

Protein in Urine and Kidney Function

Another key indicator of preeclampsia is the presence of protein in urine, detected through urinalysis at prenatal visits. In a healthy pregnancy, little to no protein should be present in urine. The presence of protein—specifically 300 milligrams or more of protein in a 24-hour urine collection, or 1+ protein or higher on a standard urine dipstick—signals that the kidneys may not be functioning properly. Protein in the urine, combined with high blood pressure, helps healthcare providers diagnose preeclampsia.

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The kidneys are bean-shaped organs that filter waste from the blood to create urine. They also help maintain fluid balance and regulate blood pressure. In preeclampsia, changes in blood vessels affect how the kidneys work, allowing protein—which normally stays in the bloodstream—to leak into the urine. This happens because the kidney's delicate filtering units become damaged or overly permeable.

A urine sample collected at each prenatal visit is routinely tested for various substances, including protein, glucose, and signs of infection. The healthcare provider will mention if protein is detected. If preeclampsia is suspected based on high blood pressure and urine protein, additional testing may include a 24-hour urine collection (collecting all urine produced over 24 hours) and blood tests to check kidney function more thoroughly. Blood tests may measure creatinine and blood urea nitrogen (BUN), which indicate how well the kidneys are filtering waste.

Kidney involvement in preeclampsia is significant because severely impaired kidney function can affect the health of both the pregnant person and the baby. In most cases, kidney function returns to normal after delivery, but monitoring during pregnancy ensures that kidney problems do not become dangerous. Pregnant people should never hesitate to ask what their urine test results show and what any findings mean for their pregnancy.

Practical Takeaway: Protein detected in urine during routine prenatal testing, combined with high blood pressure, indicates possible preeclampsia. Routine urine screening at each prenatal visit helps catch this sign early.

Physical Symptoms That May Indicate Preeclampsia

While many cases of preeclampsia cause no noticeable symptoms beyond elevated blood pressure, some pregnant people do experience warning signs. Recognizing these symptoms and reporting them to a healthcare provider is important. One common symptom is severe or persistent headache that does not improve with rest or over-the-counter pain relief. Unlike typical pregnancy headaches, headaches from preeclampsia are often described as intense and different from headaches the person has experienced before.

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Upper abdominal pain, particularly in the upper right portion under the ribcage, is another symptom that may indicate preeclampsia. This pain feels different from normal pregnancy discomfort and is often described as sharp or pressing. Swelling in the face, hands, and feet can occur in preeclampsia, though some swelling is normal in pregnancy. The distinction is that preeclampsia-related swelling may develop suddenly and be more severe than typical pregnancy swelling. A person might notice that rings no longer fit or that facial puffiness appears overnight.

Visual changes can also signal preeclampsia. These include blurred vision, seeing flashing lights, or temporary vision loss. Changes in vision occur because preeclampsia affects blood vessels throughout the body, including those in the eyes. Nausea and vomiting in the later stages of pregnancy may also occur with preeclampsia. Additionally, some pregnant people with preeclampsia report decreased urination or changes in urine output.

It is important to note that many of these symptoms can result from other pregnancy-related conditions or unrelated illnesses. For example, headaches and nausea are common in pregnancy for various reasons. However, the combination of symptoms—particularly high blood pressure with these signs—suggests preeclampsia. Pregnant people should contact their healthcare provider promptly if they experience severe headache, upper abdominal pain, visual changes, or decreased urination, especially in the second and third trimester.

Practical Takeaway: Severe headaches, upper abdominal pain, sudden swelling, visual changes, and nausea in the later stages of pregnancy warrant immediate contact with a healthcare provider. These symptoms combined with high blood pressure may indicate preeclampsia.

Severe Preeclampsia and Emergency Warning Signs

Preeclampsia can progress to a more dangerous form called severe preeclampsia, which involves higher blood pressure readings (160/110

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